Army Pfc. Bradley Manning, who now asks to be referred to as Chelsea, dressed as a woman in this 2010 photograph.
U.S. Army handout/Reuters/Landov
On Thursday, when Manning announced that he wants to be known as Chelsea Manning, it became clear that the subtext would become the focus and that Manning will now likely test military policy on transgender issues.
(NPR, like other news outlets, is at this point continuing to refer to the soldier as "Bradley Manning" on first reference.)
Cecilia Chung, a senior strategist for the Transgender Law Center in California, says Manning is walking into little-known territory. In a statement, Manning said that as part of his transition, he would seek to "begin hormone therapy as soon as possible."
But Manning, who was sentenced to 35 years in prison over the largest leak of classified information in U.S. history, is expected to serve his time at Ft. Leavenworth in Kansas. The historic military prison has just 515 beds and not a single female prisoner.
And while in the civil system, Chung said, courts have decided that not providing hormone therapy to inmates is cruel and unusual punishment, the same isn't so of the military. Court House News Service spoke to Kimberly Lewis, a spokeswoman at Ft. Leavenworth, who said that while Manning will have access to a psychiatrist and psychologist, the Army "does not provide hormone therapy or sex-reassignment surgery for gender identity disorder."
Manning's lawyer, David Coombs, said in an interview with NBC's Today that he hopes Fort Leavenworth does the right thing.
"If Fort Leavenworth does not, then I'm going to do everything in my power to make sure they are forced to do so," he said.
"It's too early to jump into any sort of conclusions," Chung said. "Gender dysphoria is a medical diagnosis and as with any medical diagnosis it is related to appropriate patient care and if that is a diagnosis that Chelsea Manning's doctor and psychiatrist have deemed appropriate for her to seek treatment, I believe it is within a patient's right to continue to require treatment."
Aaron Belkin, a political science professor who is director of the Palm Center, which focuses its research on sexual minorities in the military, says we know relatively little about transgender people in the military.
What is clear, however, is that the military has exclusionary policies that were not affected by the repeal of the law known as "don't ask, don't tell."
Belkin said that like they do for people suffering with asthma, the military has medical regulations that list being a "transexual" as an "unallowable medical condition."
"There are also general rules on conduct unbecoming an officer and regulations about dress and uniform standards," Belkin said.
That said, Belkin added, there are about 120 transgender people in an online support group for active duty transgender service members. Scholars are working on a number for how many are serving in the military currently, but, Belkin said, that number could run well into the thousands.
Jody L. Herman, the manager of transgender research at the Williams Institute, says this is an issue that should be important to the military.
For a paper she co-authored for the LGBTQ Policy Journal, Herman sifted through the National Transgender Discrimination Survey and found that transgender people were twice as likely to be in the military than their civilian peers. Herman says that a new study published in the American Journal of Public Health by former Air Force psychologist George Brown may mean that number is much higher, because it found that the number of veterans seeking treatment for transgender issues doubled in the past decade.
As Herman explained in her paper, Brown was also the one who published a groundbreaking paper in 1988 titled "Transsexuals in the Military: Flight Into Hypermasculinity."
Brown posited that people who transitioned from male to female, joined the military in an effort to "correct or repress feelings of incongruence of sex assigned at birth." In other words, they sought relief from their feelings by fleeing to a "hypermasculine" environment.
Brown continued his studies and in 2010 he studied the records of 70 active duty service members and veterans who were evaluated for gender-related issues. He and his research partners found that most of the servicemen described wanting to join the military for that reason and they also found that "military service provided no relief from their distress."
Herman says that as far as veterans are concerned, that may be changing.
"The [Veteran's Administration] system has over the past few years — since 2011 — been working hard to increase cultural competency... they've been working to improve health care delivery for transgendered people in the VA system," Herman said.
And like gay and lesbians before them, transgender people are finding more acceptance in society. One big sign of that came with the release of the latest version of the Diagnostic and Statistical Manual of Mental Disorders — or DSM-V, for short — earlier this year. As the Huffington Post reported, the manual — which renamed Gender Identity Disorder to Gender Dysphoria — changed the emphasis from the issue of identity to the distress about an incongruence between the assigned sex and the identification.
"The perspective change is similar to a decision made in 1973, when the American Psychiatric Association eliminated homosexuality from its disorders' list," The Huffington Post reports.
In the military, however, the reality may be very different.
The Washington Post reports that in a 2011 memo, the U.S Bureau of Prisons directed wardens to allow inmates seeking hormone replacement therapy to undergo an assessment. The protocol for military prisons is uncertain. Even in some state prisons, the paper reports, "transgender inmates have been denied the right to be housed with their desired gender and given hormone therapy."
"If this is really the case," Chung said about Manning's gender dysphoria, "we'll have an opportunity to work with Department of Defense to come up with an appropriate policy."